Zena Elizabeth Helen Moore

Royal College of Surgeons in Ireland | RCSI · School of Nursing and Midwifery

Hard-to-heal wounds are a common side-effect of diabetes, obesity, pressure ulcers and age-related vascular diseases, the incidences of which are growing worldwide. The increasing financial burden of hard-to-heal wounds on global health services has provoked technological research into improving wound diagnostics and therapeutics via 'smart' dressi...

Purpose: To explore the effect of silicone dressings on the prevention of pressure injuries in patients cared for in the acute care setting. Three main comparisons were explored: silicone dressing versus no dressing, all anatomical areas; silicone dressing versus no dressing on the sacrum; and silicone dressing versus no dressing on the heels. Me...

Aims: To assess patients' and nurses' perceptions and experiences of subepidermal moisture scanning acceptability. Design: Descriptive, qualitative, sub-study, embedded within a pilot randomized control trial. Methods: Ten patients who were in the intervention arm of the pilot trial and 10 registered nurses providing care for these patients on...

Background Sarcopenia is a multifactorial loss of muscle mass that can complicate surgical outcomes and increase morbidity and mortality. Parastomal hernias can occur after any surgery requiring stoma formation and is an area of concern as a complication as it can require a second surgery or emergency surgical intervention. Aim To assess the impac...

Objective: Pressure ulcers (PUs) commonly occur over bony prominences and are notoriously difficult to treat. Proinflammatory cytokines are substances that initiate the inflammatory process preceding PU development. The aim of this review was to assess whether the increased presence of proinflammatory cytokines could potentially be used as an earl...

Background Intracranial pressure (ICP) monitoring and cerebral perfusion pressure (CPP) monitoring are long established adjuncts in the management of traumatic brain injuries (TBIs). However, brain tissue oxygenation (PbtO 2 ) monitoring, used in conjunction with ICP or CPP monitoring, is an additional element that could be used in directing the ma...

Objectives To ascertain the impact of home non-invasive ventilation (NIV) on the health-related quality of life (HRQL) of patients with moderate-to-severe chronic obstructive pulmonary disease (COPD). Design Systematic review. Methods A preliminary search of computerised databases (CINAHL, Medline, Clinical Key, Cochrane) was conducted in June 20...

Objective After launching the 2019 International Pressure Ulcer/Injury Guideline, the National Pressure Injury Advisory Panel (NPIAP), the European Pressure Ulcer Advisory Panel (EPUAP) and the Pan Pacific Pressure Injury Alliance (PPPIA) collaborated with Sensorydata Corp., US, to develop a guideline app (InterPIP App). The app was designed to: pr...

This study aimed to investigate the impact of sub epidermal moisture (SEM) measurement and targeted pressure ulcer (PU) prevention, versus visual skin assessment and usual care, on mean SEM delta scores and early pressure ulcer development in acute hospital patients. A quantitative quasi‐experimental observational approach was used. A total of 149...

The aim of this feasibility study was to investigate the impact of inflammation management on wound pH, temperature, and bacterial burden, using the principles of TIME and Wound Bed Preparation. A quantitative non-comparative, prospective, descriptive observational design. Following ethical approval, 26 participants with 27 wounds of varying aetiol...

Background: Prone positioning has been widely used to improve oxygenation and reduce ventilator-induced lung injury in patients with severe COVID-19 acute respiratory distress syndrome (ARDS). One major complication associated with prone positioning is the development of pressure ulcers (PUs). Aim: This study aimed to determine the impact of a p...

Objective The aim of this clinically orientated paper is to offer an overview of diabetic foot ulcer (DFU) dressings generally, and more specifically, their use in the treatment of DFUs. Method The TIME clinical decision support tool (CDST) has been used as a clinical tool that can help clinicians bring together the different aspects of dressings...

Objective To determine the impact of lower limb lymphoedema (LLL) on health-related quality of life (HRQoL), and to identify the methodologies used to assess HRQoL and their adherence to the World Health Organization (WHO)-recommended HRQoL dimensions. Method A systematic review was used following the PRISMA guidance. Studies were eligible if they...

Objective The aim was to assess evidence related to the measuring of subepidermal moisture (SEM) to detect early, nonvisible development of pressure ulcers (PUs). Method Using systematic review methodology, all quantitative animal and human research studies written in English were considered. In January 2021, PubMed, CINAHL, SCOPUS, Cochrane and E...

Pressure ulcer (PU) prevention in the intensive care unit (ICU) is an important clinical issue as critically unwell patients are at high risk of developing PUs. However, current methods of PU detection are limited, especially for early detection. This study aimed to establish the correlation between Interleukin‐1α (IL‐1α)/total protein (TP) and sub...

This systematic review aimed to examine skin hydration and determine if this biophysical parameter can predict pressure ulcer development in at risk adults. A literature search was conducted in March 2022, using PubMed, CINAHL, SCOPUS, Cochrane, and EMBASE databases. A total of 1727 records were returned, with 9 studies satisfying the inclusion cri...

This meta-review aimed to appraise and synthesise findings from existing systematic reviews that measured the impact of compression therapy on venous leg ulcers healing. We searched five databases to identify potential papers; three authors extracted data, and a fourth author adjudicated the findings. The AMSTAR-2 tool was used for quality appraisa...

Objective: This systematic review assesses the effects of care bundles on the incidence of surgical site infections (SSIs). Data sources: The search was conducted between February and May 2021, using PubMed, CINAHL, SCOPUS, Cochrane, and EMBASE databases. Study selection: Studies were included if they used systematic review methodology, were i...

Wounds continue to be of a global concern. Therefore, a more focussed, evidence‐based approach to wound assessment and management is required. The WOUND COMPASS™ Clinical Support App (CSA) is designed to support the health care professional with wound assessment and management at the point of care. This real‐world pilot study aimed to determine the...

Early transition to full enteral intake reduces the risk of nosocomial infection and metabolic complications related to prolonged use of parenteral nutrition. Evidence on what feed advancement rates will reduce these complications and minimize extrauterine growth restriction is necessary. This is a systematic review to determine the efficacy and sa...

The present study sought to explore the impact of movement monitoring devices on risk prediction and prevention of pressure ulcers (PU) among adults. Using systematic review methodology, we included original research studies using a prospective design, written in English, assessing adult patients' movement in bed, using a movement monitoring device...

Aim Sub-epidermal moisture scanning (SEMS) is a novel point-of-care technology that measures localised oedema and detects early tissue damage that may develop into a pressure injury (PI). It provides objective data that may assist PI prevention (PIP) decision making. This study aimed to determine the feasibility of undertaking a definitive randomis...

Purpose: Educating patients to self-manage chronic diseases such as asthma is a key role for nurses. The success of this education is often limited by low patient self-efficacy. In this study, we hypothesized that the self-efficacy of patients could be enhanced if their education was based on biofeedback of their own self-management, following a nu...

Background: EM has been hypothesized to help prevent the development of ICU acquired weakness and may therefore result in positive outcomes for ICU patients. Aim: To establish the impact of Early mobilization (EM) on adult Intensive Care Unit (ICU) patients in terms of ICU length of stay (LOS), as well as hospital LOS, duration of mechanical ven...

Aim The aim of this systematic review was to determine the impact that specialist community palliative care teams (SCPCT) have on acute hospital admission rates in adult palliative care (PC) patients who require End of Life Care (EOLC). Method Using systematic review methodology, eight studies were obtained from thorough searching of CINAHL, Medli...

Aim: To examine the impact that patient violence, experienced in the Emergency Department has on emergency nurses' intention to leave their job. Background: Emergency Departments have become known for their overcrowding, chaos, unpredictability, and violence. Emergency nurses are at high risk of experiencing workplace violence which is cited in...

There is no qualitative systematic review of nurses' perceptions of their interactions with people hearing voices. There are some studies exploring the interventions provided by community psychiatric nurses to people hearing voices; these give a sense of what interactions may contain. Nurses across both community and inpatient mental healthcare set...

Background Subarachnoid haemorrhage is a form of stroke, classified as traumatic or aneurysmal in origin. Subarachnoid haemorrhage from aneurysmal rupture can cause significant side effects—most frequently, cerebral vasospasm, which increases the risk of developing delayed cerebral ischaemia. Medical and endovascular interventions differ between in...

Objective: To compare the predictive ability of subepidermal moisture (SEM) measurement versus traditional risk assessment and visual skin assessment (VSA) as means of detecting early pressure ulcer (PU) damage development among adults undergoing surgery. Method: A non-experimental, comparative, descriptive cohort study design was used. Followin...

p>Although great strides have been made to tackle hospital-acquired pressure ulcers (HAPUs), there is a need for greater recognition of device-related pressure ulcers (DRPUs), including their causes, management and prevention. This consensus statement, an updated second edition, aims to continue raising awareness of these largely preventable injuri...

Objective: The primary objective of this systematic review was to determine the effect of vasopressor agents on the development of pressure ulcers (PUs) among critically ill patients in intensive care units (ICUs). The secondary outcome of interest was length of stay in the ICU. Method: A systematic review was undertaken using the databases sear...

The aim of this study was to determine the impact of a specially designed care bundle on the development of facial pressure injuries among frontline health care workers wearing personal protective equipment (PPE) during the COVID‐19 pandemic. This was a mixed methods study. First, a pre‐posttest observational design was employed to evaluate the imp...

Aim: This review explores the impact of skincare bundles on the development of skin tears in older adults (≥65 years). Method: A systematic search of publications using MEDLINE, CINAHL and Cochrane databases was conducted in July 2020. The evidence-based librarianship (EBL) checklist assessed the methodological quality of the included studies. D...

Objectives The aim of this systematic review (SR) is to establish if video is a beneficial teaching method when teaching psychomotor skills in nursing. Design Systematic review. Data sources A database search of CINAHL, MEDLINE, EMBASE and Cochrane was performed with search terms ‘video’, ‘nurse’ ‘RCT’ and ‘practical skills’ resulting in seventy-...

Objective The use of combined ultrasound and electrostimulation (CUSECS) as an adjunct therapy for diabetic foot ulcers (DFUs) is a relatively new concept. This study aimed to investigate if combined ultrasound and electrostimulation is an effective adjunctive treatment for hard-to-heal DFUs when compared with standard wound care. Methods A random...

To assess the impact of topical agents and dressings on surface wound pH, temperature, and subsequent wound healing. This was a systematic, narrative review of the literature, following the PRISMA (2020) guidelines. The databases searched were Medline PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, Embas...

IntroductionIn orthopaedic surgery, hip fracture patients represent one of the largest cohorts. Hip fracture is a serious injury commonly occurring in frail and elderly patients. Fast-track admission pathways aim to streamline patients through accident and emergency departments, resulting in shorter wait times and less negative patient outcomes.Aim...

Objective Numerous systematic reviews have examined the impact of prone positioning on outcomes, including pressure injury (PI). The objective of this meta-review was to synthesise the evidence on the effect of prone positioning on the incidence and location of PIs in adult intensive care unit patients. Review method This is a meta-review of publi...

Objective To test the feasibility of using a standardised data collection tool to estimate the cost of stage 2–4 pressure ulcer (PU) care within an acute care setting. Method Data on resource use and cost were obtained through a retrospective survey of nursing and medical notes collecting cost data for individual patients who received care for sta...

Background: A pressure ulcer (PU) is a localized injury to the skin or underlying tissue usually over a bony prominence. The prevention PU per patient per day is costly; therefore, the detection of a PU at its earliest stage is imperative to afford timely interventions. Currently, there are very few clinically useful tools to assist with early PU...

PURPOSE: The purpose of this evidence search was to review past and current kangaroo care practice and explore the Iiterature relating to improving kangaroo care for preterm infants. METHOD: A literature review of evidence was undertaken in order to answer pre specified questions. The literature search was undertaken on CINAHL, Google Scholar and P...

Objective: The aim of this systematic review was to determine the impact of topical oxygen therapy (TOT) on diabetic foot ulcer (DFU) healing. Method: Using systematic review methodology, we considered randomised controlled trials (RCTs), controlled trials, pilot studies and observational studies. The search was conducted in January 2019, using...

Optimising outcomes for pregnant women with genetic disease has received increasing attention.1 Improved early diagnosis and management of genetic disease, together with access to prenatal diagnostics, has meant that more women are reaching reproductive age and are able to make informed choices relating to pregnancy and childbirth.2 Despite these a...

Background Consumer engagement is a requirement of high quality clinical guidelines. Developing strategies to engage consumers and incorporate the perspectives of individuals with or at risk of pressure ulcers/injuries and their informal caregivers was one priority in the recent update of the EPUAP/NPIAP/PPPIA's Prevention and Treatment of Pressure...

Aim To examine the impact of team triage on waiting times in adult emergency departments. Design A systematic review using narrative analysis. Method Systematic review methodology, which included quantitative research papers consisting of randomized control trials, cohort or quasi-experimental studies. The PICO framework was used to formulate the...

Purpose The aim of this systematic review was to determine the impact of specialist palliative care consultations in outpatient settings on pain control in adults suffering from cancer. Methods Systematic Review. Databases CINAHL, Medline, PsychInfo, and Embase were searched in February 2021. Relevant studies were also hand-searched and grey liter...

Introduction: Pressure injuries (PIs) are a global health concern. Current PI care standards, including skin tissue assessments (STA) and health care professional (HCP) clinical judgment, diagnose visibly manifested PIs on the skin's surface, i.e. after the damage has already occurred. However, objective assessment of early-stage, non-visible, pre...

Pressure ulcers (PUs) have a profound impact on individuals, with studies demonstrating that compared with similarly aged persons, those living with a PU have a significantly lower quality of life. The aim of this study was to explore the impact of the Shanley Pressure Ulcer Prevention Programme (SPUPP) on older persons' knowledge of, and attitudes...

Background: Pressure ulcer (PU) development begins with an inflammatory response, arising due to pressure and shear forces causing changes to the cytoskeletal structure of cells. Thus, pain, synonymous with inflammation, may be an indicator of PU development. Aim: To explore the role of pain as an indicator of PU development and to determine how...

Aim: To examine the effectiveness of discharge planning on length of stay and readmission rates among older adults in acute hospitals. Background: Discharge planning takes place in all acute hospital settings in many forms. However, it is unclear how it contributes to reducing patient length of stay in hospital and readmission rates. Evaluation...

Aim To determine the impact of larval therapy on the debridement of venous leg ulcers, in comparison to other debridement methods or no debridement. Method Using systematic review methodology, published quantitative studies focusing on the effect of larval therapy on the debridement of venous leg ulcers were included. The search was conducted in J...

Background: Surgical site infection (SSI) is a common postoperative concern. Purpose: To provide an in-depth understanding of the lived experience and quality of life (QoL) of individuals with SSI. Methods: A systematic search for published studies that explored the impact of SSI on QoL among adult patients (older than 18 years) who had underg...

Risk stratification to assess healthcare outcomes among older people is challenging due to the interplay of multiple syndromes and conditions. Different short risk-screening tools can assist but the most useful instruments to predict responses and outcomes following interventions are unknown. We examined the relationship between a suite of screenin...

The objectives of this study were to examine the knowledge and attitude of Indonesian community nurses regarding Pressure Injury (PI) prevention. A cross‐sectional design was used and included the community nurses permanently working in the Public Health Center (Puskemas) in Bandung, West Java Indonesia. Knowledge was measured using the Pressure Ul...

Background: Leg ulcers are open skin wounds that occur below the knee but above the foot. The majority of leg ulcers are venous in origin, occurring as a result of venous insufficiency, where the flow of blood through the veins is impaired; they commonly arise due to blood clots and varicose veins. Compression therapy, using bandages or stockings,...

Objective Lymphoedema is a debilitating condition that results in the swelling of one or more limbs, leading to a significant impairment of mobility. From a psychosocial perspective, body image and quality of life (QoL) are also adversely affected. To date, non-cancer lymphoedema has been under-researched. The primary objectives of this study were...

Objectives The aim of this study was to determine the impact of a specially designed care bundle on the development of facial pressure injuries (PI) among frontline healthcare workers wearing personal protective equipment (PPE) during the COVID-19 pandemic. The primary outcome of interest was the incidence of facial PIs. The secondary outcomes of i...

Medical devices provide effective therapeutic care for patients. However, medical device-related pressure injuries (MDRPI) are caused by prolonged pressure or shear from a medical device on any location on the body, including mucosal cavities. The primary outcome of this quantitative systematic review was to identify the incidence of MDRPIs in adul...

Background: Pressure ulcers (PUs) are injuries to the skin and underlying tissues that occur most commonly over bony prominences, such as the hips and heels as a result of pressure and shear forces. PUs cause pain, discomfort, longer hospital stays, and decreased quality of life. They are also very costly to treat and consume substantial parts of...

Pressure ulcers (PUs) negatively affect quality of life (QoL) and cause problems for patients, such as pain, distress and often specific difficulties with treatments used to manage the wound. Thus, it is important to implement appropriate prevention strategies in order to achieve high-quality care, thereby reducing the burden of PUs on patients, th...

Background Pressure injuries are one of the most frequently occurring, yet preventable hospital-acquired adverse events. Given there are many clinical practice guidelines available on the prevention and treatment of pressure injuries, it is useful to understand the quality of these guidelines and the clinical application of their recommendations....

Background The incidence and prevalence of pressure ulcers in critically ill patients in intensive care units (ICUs) remain high, despite the wealth of knowledge on appropriate prevention strategies currently available. Methods The primary objective of this systematic review was to examine the economic impact of pressure ulcers (PU) among adult in...

Chronic obstructive pulmonary disease (COPD) patients have been known to have poor medication adherence rates. The purpose of this systematic review was to assess if outreach services could impact on medication compliance rates. CINAHL, Medline, Clinical Key and Cochrane library were all searched electronically along with grey literature for all el...

Aim: the aim of this contemporary paper is to challenge the premise that the term "eHealth" is relatable to patient or service users only. It will be critically explored if the term can be broadened to include neonatal nurse education. Methods: the critical discussion will identify and review past and current literature relating to eHealth and its...

There are many reasons for practice variation in wound management. There is no universal solution to reducing or removing variation in clinical practice, so greater standardisation may be required to help structure how clinicians assess and manage wounds. Effective assessment is a key aspect of setting patients and their wounds on the path towards...

Objective: The aim of this systematic review was to assess the effects of different repositioning regimens on pressure ulcer (PU) incidence in at-risk adult individuals without existing PUs. Method: Using systematic review methodology, randomised controlled trials (RCTs), including cluster-RCTs, prospective non-RCTs, pre-post-studies and interru...

Background: Foot ulcers in people with diabetes are non-healing, or poorly healing, partial, or full-thickness wounds below the ankle. These ulcers are common, expensive to manage and cause significant morbidity and mortality. The presence of a wound has an impact on nutritional status because of the metabolic cost of repairing tissue damage, in a...

Purpose: To describe relationships between subepidermal moisture (SEM) and visual skin assessment of pressure injury (PI) in children. Design: Prospective descriptive study. Subjects and setting: Twenty-four participants aged 8 to 16 years recruited from a pediatric orthopedic unit in a children's hospital in Ireland. Methods: Subepidermal m...

This paper aims to discuss the literature pertaining to early pressure‐shear induced tissue damage detection, with emphasis on sub‐epidermal moisture measurement (SEM). The current method for pressure detection is visual skin assessment (VSA); however, this method is fraught with challenges. Advances in early detection of pressure ulcers are report...

Purpose: Population ageing is challenging healthcare systems with limited resources, necessitating the development of new care models to address the needs of older, frail community-dwellers. Community Virtual Wards (CVW) reduce adverse events in these patients. We examined the effect of an established CVW on pre-defined health trajectories (betwee...

Background In order to overcome inconsistencies in the reporting of outcomes in clinical trials, core outcome sets (COS) have been developed in many clinical areas and the awareness of this concept is growing steadily. The Outcomes for Pressure Ulcer Trials (OUTPUTs) project aims to improve the quality of evidence on pressure ulcer prevention trial...

Objective Pressure ulcers (PUs) involve the destruction of skin and underlying tissue due to prolonged pressure and shear forces. These ulcers are painful and significantly reduce a person's quality of life. PUs are also expensive to manage and impact negatively on the achievement of cost-effective, efficient care delivery. Method Prone positionin...

Background There are many high-quality systematic reviews to inform practice around pressure injury (PI) prevention and treatment. However, they are often unable to provide recommendations for practice and research due to low quality trials. Objectives To evaluate current systematic review evidence on the prevention and treatment of PI. Methods T...

Aim To identify how activity and mobility lead to pressure ulcer development, using two objective assessments, one for mobility and one for early pressure ulcer detection. Methods 150 older persons from long‐term settings were followed‐up for 20 days, using an observational, quantitative, prospective study design. The study was conducted in accord...

There has been an ongoing debate in the healthcare community about what pressure ulcers/injuries are, and how to name, define and classify them. The aim of this discussion paper is to provide a brief theoretical background about pressure ulcer/injury classification, to explain the approach the Guideline Governance Group has taken during the 2019 up...